Study Explored Potential of Defocus-inducing Virtual Reality Headset to Slow Pediatric Myopia

A short daily session with a virtual reality (VR) headset was associated with somewhat slower axial elongation and refractive progression in children with myopia, according to a randomized clinical trial published in JAMA Ophthalmology. Researchers in China found that the use of this protocol was well tolerated over six months, although the small differences observed may not yet translate into meaningful long-term benefits.

The trial included 120 children aged six to 12 years with myopia ranging -0.75D to -6.00D. The children had regular astigmatism of 2.50D or less, anisometropia of 1.50D or less and BCVA of 20/25 or better. Children with ocular conditions such as strabismus, amblyopia, glaucoma, uveitis and keratoconus were excluded, as were those with systemic diseases such as diabetes. Participants also could not have used another myopia control treatment during the previous six months.

Patients were randomly assigned to wear either single-vision spectacles alone or spectacles with digital defocus vision training (DDVT) sessions daily. The treatment used a head-mounted VR device “that uses image simulation to generate specific optical aberration signals, converts them via ray-tracing technology into a quantified retinal defocus stimulus and integrates VR to deliver intelligent defocus visual navigation.” After undergoing one to two days of required familiarization training, patients completed 15-minute training sessions at home each evening between 8pm and 10pm while wearing their spectacles. Parents supervised the sessions and the device automatically recorded compliance.

At six months, axial length had increased by 0.15mm in the DDVT group compared with 0.25mm in the spectacle-only group. Spherical equivalent refraction changed by -0.23D and -0.46D, respectively. The researchers acknowledged in their paper that the “absolute change was small,” noting that the clinical significance of the difference remained uncertain because of the short follow-up.

The intervention was also deemed safe. BCVA, intraocular pressure and OCT findings remained within normal ranges, and no training-related adverse events were reported. Accommodative facility and choroidal thickness also increased during the study, although these exploratory measures were assessed only in the DDVT group and therefore could not establish a treatment effect.

The authors acknowledged several limitations, including the lack of a sham VR group, the six-month follow-up and “the inclusion of only Chinese children.” They called for larger, longer sham-controlled studies to determine whether DDVT could become a useful adjunct for pediatric myopia control.

This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.